This meta-analysis aims to assess the efficacy and safety of tedizolid, compared to linezolid, in the treatment of acute bacterial skin and skin structure infection (ABSSSI). PubMed, Web of Science, EBSCO (Elton B. Stephens Co.), Cochrane Library, Ovid Medline and Embase databases were accessed until 18 July 2019. Only randomized controlled trials (RCTs) comparing the efficacy of tedizolid with linezolid for adult patients with ABSSSIs were included. The outcomes included the clinical response, microbiological response, and risk of adverse events (AEs). A total of four RCTs involving 2056 adult patients with ABSSSI were enrolled. The early clinical response rate was 79.6% and 80.5% for patients receiving tedizolid and linezolid, respectively. The pooled analysis showed that tedizolid had a non-inferior early clinical response rate to linezolid (odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.77–1.19, I² = 0%). The early response rate was similar between tedizolid and linezolid among patients with cellulitis/erysipelas (75.1% vs. 77.1%; OR = 0.90, 95% CI = 0.64–1.27, I² = 25%), major cutaneous abscess (85.1% vs. 86.8%; OR = 0.93, 95% CI = 0.42–2.03, I² = 37%) and wound infection (85.9% vs. 82.6%; OR = 1.29, 95% CI = 0.66–2.51, I² = 45%). For methicillin-resistant Staphylococcus aureus patients, tedizolid had a favorable microbiological response rate of 95.2% which was comparable to linezolid (94%) (OR = 1.19, 95% CI = 0.49–2.90, I² = 0%). In addition to the similar risk of treatment-emergent AEs (a serious event, the discontinuation of the study drug due to AEs and mortality between tedizolid and linezolid), tedizolid was associated with a lower risk of nausea, vomiting and abnormal neutrophil count than linezolid. In conclusion, once-daily tedizolid (200 mg for six days) compared to linezolid (600 mg twice-daily for 10 days) was non-inferior in efficacy in the treatment of ABSSSI. Besides, tedizolid was generally as well tolerated as linezolid, and had a lower incidence of gastrointestinal AEs and bone marrow suppression than linezolid.

This study aims to assess the clinical efficacy and safety of eravacycline for treating complicated intra-abdominal infection (cIAI) in adult patients. The PubMed, Web of Science, EBSCO, Cochrane databases, Ovid Medline, Embase, and ClinicalTrials.gov were searched up to May 2019. Only randomized controlled trials (RCTs) that evaluated eravacycline and other comparators for the treatment of cIAI were included. The primary outcome was the clinical cure rate at the test-of-cure visit based on modified intent-to-treat population, microbiological intent-to-treat population, clinically evaluable population, and microbiological evaluable population, and the secondary outcomes were clinical failure rate and the risk of adverse event. Three RCTs were included. Overall, eravacycline had a clinical cure rate (88.7%, 559/630) at test-of-cure in modified intent-to-treat population similar to comparators (90.1%, 492/546) in the treatment of cIAIs (risk ratio (RR), 0.99; 95% confidence interval (CI), 0.95–1.03; I² = 0%, Figure 3). In the microbiological intent-to-treat, clinically evaluable, and microbiological evaluable populations, no difference was found between eravacycline and comparators in terms of clinical cure rate at test-of-cure (microbiological intent-to-treat population, RR, 0.99; 95% CI, 0.95–1.04; I² = 0%, clinically evaluable population, RR, 1.00; 95% CI, 0.97–1.03; I² = 0%, microbiological evaluable population, RR, 0.98; 95% CI, 0.95–1.02; I² = 0%). In addition, eravacycline had clinical failure rate similar to comparators at test-of-cure in modified intent-to-treat population (RR, 1.01; 95% CI, 0.61–0.69; I² = 0%), microbiological intent-to-treat population (RR, 1.34; 95% CI, 0.77–2.31; I² = 16%), clinically evaluable population (RR, 1.03; 95% CI, 0.61–1.76; I² = 0%), and microbiological evaluable population (RR, 1.32; 95% CI, 0.75–2.32; I² = 10%). Although eravacycline was associated with higher risk of treatment-emergent adverse event than comparators (RR, 1.34; 95% CI, 1.13–1.58; I² = 0%), no significant differences were found between eravacycline and comparators for the risk of serious adverse event (RR, 1.04; 95% CI, 0.65–1.65; I² = 0%), discontinuation of study drug because of adverse event (RR, 0.68; 95% CI, 0.23–1.99; I² = 13%), and all-cause mortality (RR, 1.09; 95% CI, 0.41–2.9; I² = 28%). In conclusion, the clinical efficacy of eravacycline is as high as that of the comparator drugs in the treatment of cIAIs and this antibiotic is as well tolerated as the comparators.

This study aimed to compare the clinical efficacy and safety of ceftaroline with those of ceftriaxone for treating community-acquired pneumonia (CAP). The PubMed, Cochrane Library, Embase, and clinicalTrials.gov databases were searched until April 2019. This meta-analysis only included randomized controlled trials (RCTs) that evaluated ceftaroline and ceftriaxone for the treatment of CAP. The primary outcome was the clinical cure rate, and the secondary outcome was the risk of adverse events (AEs). Five RCTs were included. Overall, at the test of cure (TOC), the clinical cure rate of ceftaroline was superior to the rates of ceftriaxone for the treatment of CAP (modified intent-to-treat population (MITT) population, odds ratio (OR) 1.61, 95% confidence interval (CI) 1.31–1.99, I² = 0%; clinically evaluable (CE) population, OR 1.38, 95% CI 1.07–1.78, I² = 14%). Similarly, the clinical cure rate of ceftaroline was superior to that of ceftriaxone at the end of therapy (EOT) (MITT population, OR 1.57, 95% CI 1.16–2.11, I² = 0%; CE population, OR 1.64, 95% CI 1.15–2.33, I² = 0%). For adult patients, the clinical cure rate of ceftaroline remained superior to that of ceftriaxone at TOC (MITT population, OR 1.66, 95% CI 1.34–2.06, I² = 0%; CE population, OR 1.39, 95% CI 1.08–1.80, I² = 30%) and at EOT (MITT population, OR 1.64, 95% CI 1.20–2.24, I² = 0%; CE population, OR 1.65, 95% CI 1.15–2.36, I² = 0%). Ceftaroline and ceftriaxone did not differ significantly in the risk of serious AEs, treatment-emergent AEs, and discontinuation of the study drug owing to an AE. In conclusion, the clinical efficacy of ceftaroline is similar to that of ceftriaxone for the treatment of CAP. Furthermore, this antibiotic is as tolerable as ceftriaxone.

This study aims to assess the clinical efficacy and safety of ceftaroline for the treatment of complicated skin and skin structure infections (cSSSIs) in adult patients through meta-analysis. PubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched up to April 2019. Only randomized controlled trials (RCTs) that evaluated ceftaroline and other comparators for treating cSSSIs in adult patients were included. The primary outcome was the clinical cure rate, whereas the secondary outcomes were clinical failure rate, microbiological eradication rate, relapse rate, and risk of an adverse event (AE). Five RCTs were included. Overall, ceftaroline had a clinical cure rate similar to comparators in the treatment of cSSSIs in the modified intent-to-treat population (risk ratio (RR), 1.00; 95% confidence interval (CI), 0.97–1.04; I² = 0%) and in the clinically evaluable population (RR, 1.00; 95% CI, 0.97–1.03; I² = 0%). In addition, no significant difference was observed between ceftaroline and comparators for the treatment of infection with Staphylococcus aureus (RR, 1.01; 95% CI, 0.98–1.05; I² = 0%), methicillin-resistant S. aureus (RR, 0.99; 95% CI, 0.94–1.05; I² = 0%), methicillin-susceptible S. aureus (RR, 1.01; 95% CI, 0.96–1.06; I² = 26%), Streptococcus spp. (RR, 1.07; 95% CI, 0.92–1.24; I² = 73%), and Gram-negative bacteria (RR, 0.94; 95% CI, 0.83–1.08; I² = 0%). Furthermore, ceftaroline had a similar rate of microbiological eradication (92.2% vs. 92.6%, RR, 1.00; 95% CI, 0.97–1.03; I² = 9%) and relapse (6.9% vs. 9.1%, RR, 0.48; 95% CI, 0.14–1.74; I² = 0%) as comparators. Finally, the risks of treatment-emergent AEs (RR, 0.96; 95% CI, 0.88–1.05; I² = 0%), serious AEs (RR, 1.03; 95% CI, 0.63–1.68; I² = 0%), and discontinuation of study drug due to an AE (RR, 0.86; 95% CI, 0.50–1.49; I² = 34%) did not differ significantly between ceftaroline and comparators. In conclusion, the clinical efficacy of ceftaroline is as high as that of comparators in the treatment of cSSSIs in adult patients, and this antibiotic is well tolerated like the comparators.

Background and objectives: High-flow nasal cannula (HFNC) can be used as a respiratory support strategy for patients with acute respiratory failure (ARF). However, no clear evidence exists to support or oppose HFNC use in immunocompromised patients. Thus, this meta-analysis aims to assess the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on the outcomes in immunocompromised patients with ARF. The Pubmed, Embase and Cochrane databases were searched up to November 2018. Materials and Methods: Only clinical studies comparing the effect of HFNC with COT or NIV for immunocompromised patients with ARF were included. The outcome included the rate of intubation, mortality and length of stay (LOS). Results: A total of eight studies involving 1433 immunocompromised patients with ARF were enrolled. The pooled analysis showed that HFNC was significantly associated with a reduced intubation rate (risk ratio (RR), 0.83; 95% confidence interval (CI), 0.74–0.94, I² = 0%). Among subgroup analysis, HFNC was associated with a lower intubation rate than COT (RR, 0.86; 95% CI, 0.75–0.95, I² = 0%) and NIV (RR, 0.59; 95% CI, 0.40–0.86, I² = 0%), respectively. However, there was no significant difference between HFNC and control groups in terms of 28-day mortality (RR, 0.78; 95% CI, 0.58–1.04, I² = 48%), and intensive care unit (ICU) mortality (RR, 0.87; 95% CI, 0.73–1.05, I² = 57%). The ICU and hospital LOS were similar between HFNC and control groups (ICU LOS: mean difference, 0.49 days; 95% CI, −0.25–1.23, I² = 69%; hospital LOS: mean difference, −0.12 days; 95% CI, −1.86–1.61, I² = 64%). Conclusions: Use of HFNC may decrease the intubation rate in immunocompromised patients with ARF compared with the control group, including COT and NIV. However, HFNC could not provide additional survival benefit or shorten the LOS. Further large, randomized controlled trials are needed to confirm these findings.

Objectives: This study assessed the efficacy and safety of novel β-lactam/β-lactamase inhibitor combinations in adult patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). Methods: PubMed, Web of Science, the Cochrane Library, Ovid MEDLINE, Embase and EBSCO databases were searched for randomized controlled trials (RCTs) published before September 13, 2020. Only RCTs comparing the treatment efficacy of novel β-lactam/β-lactamase inhibitor combinations with other antibiotics for HAP/VAP in adult patients were included in this integrated analysis. Results: Three RCTs were included, and no significant difference in clinical cure rate of the test of cure (TOC) was observed between the novel β-lactam/β-lactamase inhibitor combination and comparators (odds ratio [OR], 1.01; 95% CI, 0.81-1.27; I² = 35%). The 28-day all-cause mortality was 16.2% and 17.6% for patients receiving the novel β-lactam/β-lactamase inhibitor combination and those receiving comparators, respectively, and no significant difference was noted (OR, 0.90; 95% CI, 0.69-1.16; I² = 11%). Compared with the comparators, the novel β-lactam/β-lactamase inhibitor combination was associated with a similar microbiological response (OR, 1.06; 95% CI, 0.73-1.54; I² = 64%) and a similar risk of AEs (treatment-emergent AEs [TEAEs]: OR, 1.04; 95% CI, 0.83-1.30; I² = 0%; serious AEs: OR, 1.14; 95% CI, 0.79-1.63; I² = 68%; treatment discontinuation for TEAE: OR, 0.90; 95% CI, 0.62-1.31; I² = 11%). Conclusions: The clinical and microbiological responses of novel β-lactam/β-lactamase inhibitor combinations in the treatment of HAP/VAP were similar to those of other available antibiotics. These combinations also shared a similar safety profile to that of comparators.